The magazine “Der Spiegel” says that a full 18% of the whole German population went to see a doctor on Monday, October 1, 2007. This equals to 15 million people sitting in the waiting room on that Monday. This was nothing special, as the average is 8% of all Germans see a doctor on every beginning of a week. Many people go to see a doctor just because they got a mild cold, or because they want to have a nice chat once in a while with a their favorite doctor. Therefore, doctors have to work very quick. The average time that a patient sees a doctor is no longer than 3-5 minutes (mind you, I’m not talking about emergency care, but private practices).

The doctors also have to be fast because they get almost no pay at all for any checkup or treatment. I don’t recall the exact numbers, but AFAIK most doctors get less than 20 Euros per patient. Some checkups like ultrasonics at an ENT specialist pay the doctor the magnificient sum of 5 Euros. And more often than not they have to treat the patients three months for this sum, because they are not allowed no charge them for a follow-up checkup. This often leads to doctors postponing follow-up checkups to the next quarter. Or they don’t offer the treatment at all, which has recently become more and more the case, as approximately half of all German private practices are near bankruptcy.

As I wrote recently in another post, German physicians have experienced the largest income decreases of all jobs in Germany in the last 20 years, the reduction being an astonishing 50% on average. This is, of course, due to the government policy to reduce costs in health care, and the same thing is now happening in the USA, where the Congress recently passed a law that decreased Medicare payments to doctors by a whopping 25% or so.

Still, American doctors are comparatively well-off because they don’t rely as much on Medicare patients as German doctors rely on the paltry payments of government-controlled public insurance funds, to which 90% of the population have subscribed. The remaining 10% are privately insured and their insurance companies pay four, five, or even ten times as much for the same checkup or treatment.

This is the reason why a so-called “Zweiklassenmedizin” (literally: two classes of medicine) has emerged. Privately insured patients get treatment that no other patient gets. Some doctors have special hours just for the privately insured. The problem for the average German is that you have to earn more than two times the average wage in order to get permission to change from the public insurance funds to the private insurances.

Now, bear those things in mind when you hear Obama talking about how he sees the German health care system as a role model…